Journal Article

Clostridium difficile Infection Is a Risk Factor for Bacteremia Due to Vancomycin-Resistant Enterococci (VRE) in VRE-Colonized Patients with Acute Leukemia

Mary-Claire Roghmann, Robert J. McCarter, Jeanine Brewrink, Alan S. Cross and J. Glenn Morris

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 5, pages 1056-1059
Published in print November 1997 | ISSN: 1058-4838
Published online November 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516112
Clostridium difficile Infection Is a Risk Factor for Bacteremia Due to Vancomycin-Resistant Enterococci (VRE) in VRE-Colonized Patients with Acute Leukemia

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A cohort study was conducted in a cancer center to identify risk factors for bacteremia with vancomycin-resistant enterococci (VRE) in neutropenic cancer patients colonized with VRE. There were 10 patients with VRE bacteremia among 56 colonized with VRE, of whose charts 51 were available for review. One hundred percent of patients with VRE bacteremia (10 of 10) vs. 56% of patients without VRE bacteremia (23 of 41) had acute leukemia (P = .01, Fisher's exact test). Four of the 10 patients with VRE bacteremia had a positive Clostridium difficile toxin assay within 6 days of their first positive VRE blood culture. Both C. difficile infection and antimicrobial (vancomycin and ciprofloxacin) use during VRE colonization were significant risk factors for VRE bacteremia in univariate analysis. When a Cox proportional hazards model was used to account for differences in follow-up time, C. difficile infection was the only statistically significant risk factor (risk ratio, 8.2; P = .007) for VRE bacteremia in VRE-colonized patients with acute leukemia.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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